Emotion Awareness and Regulation in Individuals with Schizophrenia: Implications for Social Support

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Background: Social functioning has been a target of research and intervention in schizophrenia in recent years. Perceived social support has been implicated as protective against stress and contributing to reduced symptoms and increased use of adaptive coping skills. Research has implicated emotion awareness and regulation in social functioning deficits and suggests that improved emotion awareness and regulation may also increase chances for individuals with schizophrenia of garnering social support and expanding their social network. The aim of the current study was to examine the relationships between emotion awareness, emotion regulation, and social support through exploration of underlying mechanisms by which these variables exert effects on each other.;Methods: Participants were 90 individuals with schizophrenia-spectrum disorders and 26 healthy controls, who completed measures of emotion awareness, emotion regulation, social functioning, social support, and social networks.;Results: Consistent with previous literature, we found that compared to controls, the schizophrenia group reported lower emotion awareness (F(1,108) =26.09, p< .001), poorer global emotion regulation skills (F(4,84) = 3.30,p = .01), more frequent use of emotion suppression (F(3,87) = 3.29,p = .02), lower perceived social support (F(1,109) = 18.87, p < .001), and greater difficulty with social functioning (F(3,86) = 10.56,p < .001). Within the schizophrenia group, mediation analyses found emotion awareness to be a significant mediator of the relationship between cognitive reappraisal regulation strategy and perceived support (ab = .15, 95% CI [.05, .31]), as well as emotion suppression regulation strategy and perceived support ( ab = -.14, 95% CI [-.28, -.02]). Exploratory analyses yielded significant associations between social network size and negative symptoms (r = .63, p < .001), perceived social support ( r = .48,p = .006), and interpersonal functioning (r = .43,p = .015).;Conclusions: The current study confirms emotional and social functioning impairments in schizophrenia, and implicates emotion awareness as the link between emotion regulation strategies and social functioning outcomes. This has implications for treatment, which may need to improve emotional awareness to increase chances of successfully utilizing adaptive cognitive strategies for regulating emotions and increasing ability to perceive social support from others.